End-stage kidney disease is the complete, or almost complete failure of the kidneys to function. The kidneys can no longer remove wastes, concentrate urine, and regulate electrolytes .

Alternative Names:

Renal failure - end stage; Kidney failure - end stage; ESRD

Causes, incidence, and risk factors:

End-stage kidney disease occurs when the kidneys are no longer able to function at a level that is necessary for day-to-day life. It usually occurs when chronic kidney failure has progressed to the point where kidney function is less than 10% of normal.

The most common cause of ESRD in the U.S. is diabetes . ESRD almost always follows chronic kidney failure . A person may have kidney failure for 10 - 20 years or more before progressing to ESRD.

Dialysis or kidney transplantation are the only treatments for ESRD. Your physical condition and other factors determine which treatment is used.

When you start dialysis depends on different factors, including your lab test results, severity of symptoms, and readiness. You should begin to prepare for dialysis before it is absolutely necessary. The preparation includes learning about dialysis and the types of dialysis therapies, and placement of a dialysis access.

You may receive other treatments for chronic kidney failure, but they are unlikely to work without dialysis or a transplant. Treatment usually includes aggressive treatment of high blood pressure with an ACE inhibitor or angiotensin receptor blocker.

You will also receive treatment for diseases that cause, or are caused by chronic renal failure, including:

Without dialysis or a kidney transplant, death will occur from the buildup of fluids and waste products in the body. Both of these treatments can have serious risks and consequences. The outcome is different for each person.

Go to the emergency room or call the local emergency number (such as 911) if you develop symptoms of end-stage kidney disease. Call your health care provider if you have acute or chronic kidney failure and it continues or gets worse.

Prevention:

Treatment of chronic kidney failure may delay or prevent progression to ESRD. Some cases may not be preventable.